Complete denture, Removable
partial dentures & Recent
Advances
Dr. H. Zeenath
Assistant Professor,
Dept of Prosthodontics
Govt. Dental college, TVM
INTRODUCTION
Complete denture is defined as “A dental prosthesis
which replaces the entire dentition and associated
structures of the maxilla and mandible”.-GPT
Partialdenture:Aprosthesisthatreplacesoneor
more,butnotallofthenaturalteethand
supportingstructures.Itissupportedbytheteeth
and/orthemucosa.Itmaybefixed(i.e.abridge)
orremovable.
ACCORDING TO MATERIAL
•Metallic
•plastic
ACCORDING TO STRUCTURE
•Perforated
•Non-perforated
ACCORDING TO AREA OF
COVERAGE
-Quadrant -Section -Full
CLASSIFICATION OF
IMPRESSION TRAYS
PERFORATED & NON PERFORATED METAL AND
PLASTIC TRAYS
SECTIONAL
TRAYS
TRIPLE TRAY
RIM LOCK TRAYS
Impressions are usually poured in three pours.
Pouring the primary cast
Thecastshouldbeseparatedfromtheimpressionabout
anhouraftertheinitialset.Thepouredimpressionis
placedinawarmwaterbathtilltheimpressioncompound
softensandthecastcanbeeasilyremoved.
SPECIAL TRAY
Acustommadedevicepreparedforaparticular
patientwhichisusedtocarry,confineandcontrol
animpressionmaterialwhilemakingan
impression”.GPT
Conditioningthe primary cast
Adapting the relief wax
Adapting the spacer
Application of the separating medium and
Fabrication of a special tray
STEPS IN FABRICATION OF A
SPECIAL TRAY
Twomajortechniquescommonlyused…
SPRINKLEONTECHNIQUE
DOUGHMETHOD
TECHNIQUE IN FABRICATION OF COLD CURE RESIN
SPECIAL TRAY
SPRINKLE ON TECHNIQUE
This method is commonlyused .
PROCEDURE
Make an outlineof the impression tray on the cast with
a pencil.
Block out the severe undercuts , and adapt a layer of
modelling wax to the cast as spacer.
Paint tinfoil substitute /seperating medium over the
stone cast and the spacer .
Sprinkle polymer powder over an area onto the cast .
Saturateit with liquid monomer with a dropper .
SPRINKLE ON TECHNIQUE
Apply morepowder and liquid until a uniform
thickness of 2 mm thickness is achieved.
Mix more resin and in the doughstage, form the
handle and fix it to the impression tray.
Make the handles with 3 to 4 mm of thickness,
8mm width, and 8 mm height.
SPRINKLE ON TECHNIQUE
After setting,remove the impression tray from the cast,
andtrim using an acrylic bur.
Examine the completed tray, and adjust and polish .
Pumice the borders of the tray lightly to make surface
smooth.
SPRINKLE ON TECHNIQUE
ANGULATION OF THE HANDLE
MAXILLA :12-15 degreesMANDIBLE : 90 degrees
ADVANTAGE
This is the fastesttechnique for making special tray.
DISADVANTAGES
Expensive
A vacuum-formingmachine is required for this
procedure
VACCUM-FORMED VINYL
OR POLYSTRENE
.
VACcUM-FORMING CHAMBER
SPECIAL TRAY MADE OF LIGHT CURE RESIN
Afterfabricatingthespecialtray,itshouldbestoredin
thecasttillthenextappointment.
Acrylicspecialtraysshouldbestoredinwatertoavoid
warpage.
Shellactrayshouldbestoredinacooldryplace.
STORING THE SPECIAL TRAYS
Occlusionrimsarefabricatedfor
Arrangingartificialteeth
Recordingvariousmaxillo-mandibularrelations
Markingliplines
Recordingverticalandhorizontaloverlaps,etc.
PURPOSE OF OCCLUSAL RIM
TECHNIQUE OF FABRICATION OF OCCLUSAL RIM
Rolled wax technique
Metal occlusal rim former
Pre-formed occlusal rim
Occlusal rims can be fabricated by using the following
techniques.
Itshouldbe22mmhighfromthedepthofthe
sulcusattheregionofthecanineeminence.
Theanterioredgeoftheocclusalrimatthe
midlineshouldbeabout8mmawayfromtheincisive
papilla.
MAXILLAR Y OCCLUSAL RIM
widthofocclusaltable
anterior:4to6mm,posterior:8to12mm
heightfromthecrestoftheridge
anterior:10-12mm,posterior:5-7mm
heightfromthedepthofsulcus(posteriorly)-18mm
MAXILLAR Y OCCLUSAL RIM
ARRANGEMENT OF TEETH
INSTRUMENTS
Teeth set
Lecrons carver
Wax knife
Lead pencil
Flexible scale
Glass plate
Reference line drawn on cast
OCCLUSAL PLANE -Horizontal plane –Glass plate
SAGITAL PLANE
MID LINE
LONG AXIS OF TOOTH
VERTICAL AXIS
GUIDE LINES
Wax removal to place teeth
CENTRAL INCISOR
TO OCCLUSAL PLANECENTRAL INCISOR IN RELATION
INCISAL EDGE -0 .5-1mm SHORT OF
OCCLUSAL PLANE
LATERAL INCISOR
FRONT VEIW-LONG
AXIS PARALLEL TO
VERTICAL AXIS NECK
OF THE TOOTH IS
SLIGHTLY OUT-CANINE
PROMINENCE-DISTAL
SLOPE NOT SEEN
SIDE VEIW-LONG AXIS
PARALLEL TO
VERTICAL AXIS
OCCLUSAL PLANE -
CUSPID TIP IN CONTACT
WITH OCCLUSAL PLANE
POSITION OF CANINE
MAXILLARY CANINE IN THREE PLANES
FRONT–LONG AXIS PARALLEL TO VERTICAL AXIS
SIDE-LONG AXIS PARALLEL TO VERTICAL AXIS
OCCLUSAL PLANE -CUSPID TIPCONTACT
OCCLUSAL PLANE
ARCH FORM-use flexible scale-
canine takes a turn -corner tooth
FRONT VIEW-LONG
AXIS PARALLEL TO
VERTICAL AXIS
INCISAL EDGE 1-2 mm
ABOVE OCCLUSAL
PLANE
SIDE VIEW-SLOPES
LABIALLY
OCCLUSAL VIEW –
INCISAL EDGE FOLLOW
THE OUT LINE OF THE
OCCLUSAL RIM
MANDIBULAR-CENTRAL incisor
FRONT VIEW-LONG AXIS
PARALLEL TO VERTICAL AXIS
SIDE VIEW –LONG AXIS
SLOPES LABIALLY LESS
THAN CENTRAL INCISOR
OCCLUSAL VIEW-INCISAL
EDGE FOLLOW THE OUTLINE
OF THE OCCLUSAL RIM
MANDIBULAR –LATERAL INCISOR
FRONTVIEW-CUSPIDTIP OF THE CANINE
IS 0.5-1mm ABOVE THEOCCLUSAL PLANE
LONG AXIS IS TILTED MESIALLY
SIDE VIEW-SLOPES SLIGHTLY
LINGUALLY
OCCLUSAL VIEW -CUSPITIP SHOULD
FOLLOW OCCLUSAL RIM
MANDIBULAR -CANINE
Canine Key of Occlusion-The distal slope of lower
canine should align with mesialslope of upper canine
Improper offset results in
difficulty in arranging lower
pre molar teeth inproper
occlusion
OVER BITE=2mm
OVER JET=2mm
Completed
maxillary and
mandibular anterior
teeth -there should
not be any contact
WAX SCOOPED 1
ST
PREMOLAR
POSITIONED WITH
BUCCAL CUSP
CONTACTING OCCLUSAL
PLANE
1
ST
PRE MOLAR
1
ST
PRE MOLAR IN RELATION TO
VERTICAL AXIS-SIDE VIEW
1
ST
PREMOLAR
PALATAL CUSP
RELATION
FIRST PREMOLAR
WAX SCOOPED
BOTH BUCCAL
&PALATAL CUSPS
TOUCHES THE
OCCLUSAL PLANE
2
ND
PREMOLAR
FRONT VIEW
SIDE VIEW-LONG
OCCLUSAL VIEW
2
ND
PRE MOLAR
IN RELATIONTO VERTICAL AXIS
MAXILLARY 1
ST
MOLAR
The buccal cusps
corresponds with the
buccal cusps of pre
molars-blue line
The palatal cusps
corresponds with the
palatal cusps of
premolars –yelow line
MAXILLARY-2
nd
MOLAR
Both the buccal cusps –
blue line palatal cusps
correspondstwith-the
1
st
molar-yellow line
Antero-posterior compensatory
curve
BUCCAL ALIGNMENT
Teethy
appearance
Normal dark space
behind the canine in
smile
BUCCAL CORRIDOR
wax scooped outReference
guideline for the
central fossa of
posterior teeth
MANDIBULAR FIRST PRE MOLAR
Long axis inclined
lingually when viewed
from front
Lingual cusp below the
horizontal plane buccal
cusp slightly at a higher
level
occlusal view
lingual view
side view long axis parallel to
vertical axis
MANDIBULAR 2
nd
-PRE MOLAR
Wax scooped out
Placed along the
reference line
1
st
MOLAR
SIDE VIEW-
mesiobuccal cusp of
maxillary 1
st
molar rests
on the buccal groove of
lower 1
st
molar
LINGUAL VIEW-
mesiopalatal cusp of
maxillary 1
st
molar inter
digitates with the
central groove of lower
1st molar
Occlusal view-mandibular 2
nd
molar positioned in the
reference line
Lingual view
Side view
2
nd
MOLAR
COMPLETED TEETH ARRANGEMENT
Waxing ,carving ,festooning, stippling
Wax added to cover cervical 1/3 of the teeth on the labial
and buccal surface
Wax melted and extended to the flange
waxing
Wax carved holding the
carver at 60 degree in
the anterior region
Wax carved at 20
degree
Posterior region at 45
degree
Semi circular sketch
for root carving vertical
line with slight distal tilt
for canine
Wax removed above the
line and in between .
FESTOONING
Wax removed above the
sketch
After carving
A brush is used
STIPPLING
Involves replacing the base of waxed
portions with final denture materials
Denture processing
Sealing: denture is sealed to the cast at
its borders with molten wax
Cast separation
It helps to maintain position of the denture.
Mainly prevents plaster from getting under the
denture.
Process by which trial denture is surrounded by stone /
plaster in a metal flask .
It basically creates a mould for acrylic denture.
Flasking / Investing
Two Pour
Three Pour
Four Pour
Ideal Material For Investing -Stone
Flask-Hanauflask .
Soak the cast in slurry water.
Checking the fit .
Excess height is trimmed off.
Lubricate using petroleum jelly .
Reduces the possibility of distortion
and fracture.
Deflaskingis easier.
Three Pour Technique
Separating media is applied at base of sides.
Stone filled in the lowest portion.
Allowed to set for 20mins.
Apply separating media over 1
st
pour .
Middle portion of flask is assembled and pour the 2
nd
mix till the occlusal surfaces of teeth and allow to set
for 20mins.
Excess stone is removed to expose cusp tips .
Separating Media Is Applied Again.
Stone Mix Is Poured Filling The Remainder Of Flask.
Allow To Set For 20mins.
First Pour
Cast Is Flasked In Lower Half.
Second Pour
Rest Of The Flask Is Filled.
Difficult To Deflask
Risk Of Fracture
Risk Of Distortion
Eliminates the wax and temporary
denture base for mould space.
Place in boiling water for 5mins.
Excess time in boiling water causes
wax liquify and soak in stone.
Opened flask is flushed with
boiling water to remove remaining
wax.
Separating media is applied to the dewaxedmold
space prior to packing the acrylic resin
Objectives:
Prevent water from mold entering into resin which
may affect the rate of polymerisation.
Prevent monomer penetrating into mold material ,
causing plaster to adhere to the resin and producing a
rough surface.
Tin foil
Cellulose lacquers
Solution of alginated compounds
Calcium oleate
Soft soaps
Sodium silicate
Starches
Most commonly used separating medium is
sodium alginate solution which is also
called as ‘cold mould seal’.
Types of separating medias
Apply separating media on to the stone surface
excluding the teeth.
Mixed acrylic dough is formed into a roll and adapt
into mould space
A plastic separating sheet is placed over
the dough and 2 halves are closed with
pressure.
Polymerisation.
It is defined as forming of a compound by
joining together of molecules of small mol.Wt
into a compound of large mol.Wt.
Short Curing Cycle
Flask is kept in water at room temp and is
raised for 65 degree and maintain for 90 minutes
Boil for 1hr.
Equipment
Special Electrical Curing Chambers
Slow.
Cure at low temperature for long time for
thick dentures.
Less prone to porosity.
Temp –65-70 degree.
Time –8hrs.
No need to boil.
Long Curing Cycle
Less Risk Of Porosity.
Less Residual Monomer.
Indicated For Thick Acrylic
Appliances.
Advantages
Slow Cooling
Bench Cooling.
Fast Cooling
Bench cooling for 30mins and placing it
under running tap water for 30mins.
Cooling
FLUID RESIN TECHNIQUE
Pourable chemical activated resin
Resin is supplied in form of powder & liquid components
Very low viscosity resin
Completed tooth arrangement positioned in a fluid resin
flask
Preparation of sprues and vents for resin
Resin is poured into the mold cavity & allowed to polymerize
Flask is kept in pressureised chamber for 30 -45 mins
Recovery of complete denture prosthesis
LIGHT ACTIVATED DENTURE BASE
RESINS
Composite matrix of urethane dimethacrylate,
microfinesilica &high molecular weight acrylic resin
monomer
Activator –visible light
Initiator –camphorquinone
Supplied in sheet &rope form packed in light proof
pouches
light activated resin cannot be flaskedin conventional
manner
Opaque investing media provides the passage of light
Teeth is arranged & the denture base sculpted using
light activated resin
Denture base is placed into a light chamber
&polymerized
MICROWAVE CURING
Self clamping aluminium flask
Flasking
Dewaxing: The flask is placedin an 800W
(standard) microwave oven for 3 mins at
30% power (240W) .
Curing: The flask is placed in a 800W microwave
oven for 15 mins at 30% power (240W)
DEFLASKING
Removal of denture from flask using a wedge instrument.
Excess should be trimmed off to
reproduce the accurate details.
Abrasives
Used for polishing and finishing
irregular surfaces.
TRIMMING
Lathes Used For Trimming
Silicon carbide , boron carbide
-abrading agents.
The silicon carbide is sintered /
pressed with binder into
grinding wheels/ disks.
Eg: most of the stone burs are
made of SiC.
Carbides:
For trimming borders:
lathe mounted arbor band.
laboratory sized carbide burs.
For deeper frenum notches:
fissure bur mounted on lathe.
To remove stone in betn. Teeth/ to remove
acrylic nodules from denture:
pointed chisel/ fissure bur
Trimming:
To finish lingual border of denture:
small sized carbide bur.
To reduce thickness of palate:
large egg shaped bur.
FINE abrasives
Pumice:
Siliceous material of volcanic origin.
Used as both abrasive/polishing agent
depending on particular size.
A slurry of fine flour of pumice
with water is made.
The rag wheel is wetted using
the slurry and polished at low
speed.
In case of less accessible areas a
brush/ prophy cup with slurry is
used for polishing
High shine is produced using
no.341 TiGleam .
PUMICING PROCEDURES
Finally the denture is brushed with
green soap to remove all traces of
polishing material.
Rinse
Storage-water.
Recent advances in
complete dentures
Biofunctionalprosthetic system
BPS dentures are the product of effective
cooperation between dentists and dental
technicians.
The results are high quality tooth
replacements for discerning patients.
Impression Using Accu-Dent System
Centric Tray
Herbert Frick ICDE
Initial impressions with the Centric Tray study bite
Herbert Frick ICDE
Gnathometer Mmounted on impression trays
Upper and lower finished impressions
Perfect occlusal fit
Intra-oral bite registration
Perfect Centric
"Bite Registration"
Final Impressions with bite registration
Herbert Frick ICDE
Tool used to transfer jaw position to the laboratory (UTS 3D
transfer bow)
Stratos articulator
Mounting models using facebow
Herbert Frick ICDE
Selection of Teeth
Herbert Frick ICDE
Herbert Frick ICDE
Herbert Frick ICDE
Herbert Frick ICDE
Boiled-out upper and lower
injection flasks
Herbert Frick ICDE
Herbert Frick ICDE
Herbert Frick ICDE
Completed upper and lower dentures
Herbert Frick ICDE
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176
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Advantages of nylon flexible denture (1955)
1. Soft and inherent flexibility:
Ability to engage undercuts for retention.
No need for periodic adjustment of clasp to
keep them tight.
Low modulus of elasticity
2. Will not warp or become brittle.
3. clinically unbreakable.
4. Good biocompatibility: because it is free of
monomer and metal.
178
5. No porosity, so no bacteria can build up within it.??!!
6. No gingival inflammation
7. More comfortable
8. Absorb small amounts of water to make the denture
more soft and tissue compatible.
9. Less bulky (thinner) and lighter weight
10. Better chewing efficiency
179
11. Better esthetics: Translucent, so it allows natural
gum to show through, making it invisible.
Clasps rest on the gums surrounding the natural
teeth.
They are indistinguishable from the gums.
No metal framework
12. More retention and stability
13. Retention depends mainly on the tissue and only a
small portion of abutment tooth. No evidence of
excessive abutment mobility
14. Ease of fabrication (in comparison with cast RPD)
15. Reduces chair side time (shorter fabrication time)
180
Disadvantages of nylon flexible denture
1.Intended only for provisional or temporary
applications.
Flexible dentures are generally only used when
traditional dentures cause discomfort to the patient
and cannot be solved through relining.
181
2. A major drawback is de-bonding of the acrylic teeth
from nylon denture base. Nylon polyamide denture
base material does not bond chemically with acrylic
resin/porcelain, so mechanical undercuts (diatorics)
are made in each tooth. It cannot be used with
patients having low vertical dimension and closed
bite.
182
Main composition
Polyamide nylon thermoplastic material
Injection molding technique:
It is highly sensitive to the position and size of sprue
placement.
Investingin a special flask (e.gvalplastflask) and spruing.
Spruedesigning:
For complete maxillary dentures,sufficient width sprueis
attached to the posterior border of the denture with an
extension over the palate area to allow adequate flow of the
material throughout the palate area.
For partial dentures and mandibularcomplete dentures,the
sprueis attached to both lingual extensions as well as in
the midline.
183
Wax elimination by boiling.
Undercuts (diatorics) are made (prepared) in the
centre of each tooth so that the melted fluid
polyamide will flow into the undercuts for
mechanical retention.
After preparation, each tooth is cemented back into
its place in the top half of the flask with valcement
(cement provided with the valplast system).
N.B. Cyanoacrylate is contraindicated, because it
bonds permanently with the teeth surface.
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4. Thermoplastic nylon is melted at temperatures from
274 to 302°C for 11 min before injection.
The opened flaskis placed directly in a pre-heated
oven maintained at 65-80°C. Furnace timer was set
for 17 minutes.
The flasks halves are assembled with brackets and
together with the cartridge containing melted nylon;
they are placed on to the injection unit. The injection
molding pressure is maintained at 5 bars for 1 min.
The dental flask is bench-cooledbefore deflasking.
185